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WP0042765
EnvironmentalHealth
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4300 - Water Well Program
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WP0042765
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Entry Properties
Last modified
8/5/2022 12:02:09 PM
Creation date
8/5/2022 11:50:38 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4300 - Water Well Program
RECORD_ID
WP0042765
PE
4366
STREET_NUMBER
30051
Direction
E
STREET_NAME
GROOMS
STREET_TYPE
RD
City
OAKDALE
Zip
95361-
APN
20729060
ENTERED_DATE
11/29/2021 12:00:00 AM
SITE_LOCATION
30051 E GROOMS RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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219 <br />229 <br />SAND <br />229 <br />253 <br />SHALE <br />253 <br />258 <br />SAND <br />258 <br />303 <br />SHALE <br />303 <br />305 <br />SAND <br />305 <br />318 <br />SHALE <br />318 <br />323 <br />SAND <br />323 <br />340 <br />CLAY <br />Casings <br />Casing <br />Depth from Surface <br />Casing Type <br />Material <br />Casings Specificatons <br />Wall <br />Thickness <br />Outside <br />Diameter <br />Screen <br />Slot Size <br />if any <br />Description <br /># <br />Feet to Feet <br />119 ALBERS ROAD MODESTO CA 95357 <br />(inches) <br />(inches) <br />Type <br />(inches) <br />Signed electronic signature received 03/11/2022 668622 <br />1 <br />0 <br />250 <br />Blank <br />PVC <br />OD: 8.625 in. I SDR: <br />0.41 <br />8.625 <br />FN W <br />Latitude Deg/Min/Sec Longitude Deg/Min/Sec <br />21 1 Thickness: 0.410 <br />APN: <br />in. <br />2 <br />250 <br />270 <br />Screen <br />PVC <br />OD: 8.625 in. I SDR: <br />0.41 <br />8.625 <br />Saw <br />0.045 <br />21 1 Thickness: 0.410 <br />Cut <br />in. <br />3 <br />270 <br />290 <br />Blank <br />PVC <br />OD: 8.625 in. I SDR: <br />0.41 <br />8.625 <br />21 1 Thickness: 0.410 <br />in. <br />4 <br />290 <br />330 <br />Screen <br />PVC <br />OD: 8.625 in. I SDR: <br />0.41 <br />8.625 <br />Saw <br />0.045 <br />21 1 Thickness: 0.410 <br />Cut <br />in. <br />Annular Material <br />Depth from <br />Surface <br />Feet to Feet <br />Fill Fill Type Details <br />Filter Pack Size Description <br />0 <br />108 <br />Bentonite High Solids <br />Name MASELLIS DRILLING INC <br />108 1 <br />330 <br />Other Fill See description. <br />BIRDS EYE GRAVEL <br />Other Observations: <br />Borehole Specifications <br />Certification Statement <br />Depth from <br />I, the undersigned, certify that this report is complete and accurate to the best of my knowledge and belief <br />Surface <br />Borehole Diameter (inches) <br />Name MASELLIS DRILLING INC <br />Feet to Feet <br />Person, Firm or Corporation <br />0 340 <br />14 <br />119 ALBERS ROAD MODESTO CA 95357 <br />Address City State Zip <br />Signed electronic signature received 03/11/2022 668622 <br />C-57 Licensed Water Well Contractor Date Signed C-57 License Number <br />DWR Use Only <br />CSG # <br />State Well Number Site Code <br />Local Well Number <br />FN W <br />Latitude Deg/Min/Sec Longitude Deg/Min/Sec <br />TRS: <br />APN: <br />Form DWR 188 rev. 12/19/2017 Page 2 of 2 <br />
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